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Related Experiment Video

Updated: Feb 3, 2026

Detecting Behavioral Deficits in Rats After Traumatic Brain Injury
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Postural control deficits identify lingering post-concussion neurological deficits.

Thomas A Buckley1,2, Jessie R Oldham1, Jaclyn B Caccese1,2

  • 1Department of Kinesiology and Applied Physiology, Interdisciplinary Program in Biomechanics and Movement Science, 150 Human Performance Laboratory, University of Delaware, Newark, DE 19716, USA.

Journal of Sport and Health Science
|October 26, 2018
PubMed
Summary

Concussion impairs postural control, and current tests like the Balance Error Scoring System (BESS) lack sensitivity for recovery. Non-linear metrics show promise for detecting subtle, persistent balance deficits after mild traumatic brain injury.

Keywords:
BalanceConcussionMild traumatic brain injuryPostural controlVariability

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Area of Science:

  • Neuroscience
  • Biomechanics
  • Sports Medicine

Background:

  • Concussion (mild traumatic brain injury) incidence is high.
  • Impaired postural control is a key symptom of concussion.
  • Current subjective assessments like the Balance Error Scoring System (BESS) have low sensitivity for detecting concussion-related postural deficits and recovery.

Purpose of the Study:

  • To review linear and non-linear assessment methods for post-concussion postural control.
  • To highlight limitations of current BESS evaluations.
  • To explore the potential of advanced metrics for concussion recovery assessment.

Main Methods:

  • Review of existing literature on concussion and postural control assessments.
  • Comparison of linear (e.g., BESS, instrumented measures of stance/gait) and non-linear (e.g., approximate entropy, Shannon entropy, Renyi entropy) metrics.
  • Analysis of studies examining postural control during acute and chronic recovery phases.

Main Results:

  • Linear assessments reveal postural impairments persisting beyond BESS recovery, up to one month post-concussion.
  • Non-linear metrics, particularly approximate entropy (ApEn), detect acute postural deficits even when linear measures appear normal.
  • Some non-linear metrics indicate lingering deficits through clinical recovery and potential alterations in individuals with prior concussion history.

Conclusions:

  • Non-linear metrics offer superior sensitivity for identifying acute concussion-related postural control impairments compared to BESS.
  • Further research into non-linear metrics is crucial for understanding persistent deficits and improving concussion recovery identification.
  • Non-linear analysis presents a promising avenue for sensitive, objective assessment of concussion recovery.